The health ministry has instructed health centres in the country to strictly monitor weight and height of all children under the age of five to reduce childhood acute wasting and stunting.

The ministry issued an executive order on June 7 requiring all health facilities to immediately and strictly comply with the order.

Health secretary Dr Ugen Dophu said reports from the health facilities and monitoring visits indicate that growth monitoring has not picked up as expected.

The order states that growth assessment is important to define health and nutritional status at both individual and population level of children under five.

Dr Ugen Dophu said that parents take their child to health facilities up to one year because most of the required immunisations should be given within a year after birth. After that parents do not take the routine health check-up of children seriously. “They take their children to health centres only when their child has some illness like diarrhoea or fever.”

Dr Ugen Dophu added that health workers too do not take the matter seriously. “It is the fault of both parents and the health workers. When this continues, there is stunting and acute wasting after a period of time.”

The health centres are instructed to ensure that height and weight are measured monthly for children under one-year-old and every three months for children between one to five years of age.

“Parents are also advised to bring their children to the health facilities regularly until the child completes five years of age,” Dr Ugen Dophu said. “Health workers should also give equal attention to all children brought to the health facilities like those given to children of age one and below.”

Dr Ugen Dophu said that it is only through routine growth monitoring that the growth and development of a child can be tracked. “We can further investigate whether a child has an illness or nutritional deficiency if the child’s weight and height are found to not grow as expected. If the child has an illness, treatment can be advised accordingly.”

If symptoms of stunting and wasting is found in a child, the child will be referred to the higher grade health centres where nurses and doctors will advise special micronutrient packaged diets, Dr Ugen Dophu said. The child will be treated and observed for fifteen days or a month during which time parents will be educated on the right kind of food to be given to the child at home.

Currently, the facility is available only in the national referral hospital in Thimphu.

“We will introduce the same in other referral and district hospitals in the country,” Dr Ugen Dophu said.

Dr Ugen Dophu said that scarcity of food at home is not the issue in the country, but giving nutritional food to the child is. “Currently, when a child becomes a year old, parents feed the child what other family members eat. The child is given the amount of required food but nutrition is a problem for many children.”

Last year, Prime Minister asked the ministry to see what can be done to prevent malnutrition in pregnant women and children.

The health ministry has plans to provide special nutrient packaged food to malnourished pregnant women.

“It will cost the ministry a lot of money, but the diet will be provided to only those who require it. We have the presentation ready. It is yet to be operationalised,” Dr Ugen Dophu said.

Dechen Tshomo